Relationship between oestrogen receptor status and proliferation in predicting response and long-term outcome to neoadjuvant chemotherapy for breast cancer

Abstract

Oestrogen receptor (ER) negative breast cancers are more likely to achieve a pathological complete response (pCR) to neoadjuvant chemotherapy compared to those with ER positive tumours. ER positive tumours exhibit low proliferation and ER negative cancers high proliferation. The aim of this study was to determine to what extent the better response of ER negative cancers correlates with proliferation rate. A retrospective analysis of a prospectively maintained database identified 175 neoadjuvant chemotherapy patients with tissue available for Ki67 analysis. On univariate analysis, pre-therapy Ki67 (P = 0.04), ER status (P = 0.002), HER2 status (P = 0.004) and grade (P = 0.0009) were associated with a pCR. In a multivariate model, HER2 was the only significant predictor of pCR. No significant relationship between pre-therapy Ki67 and relapse-free and overall survival was demonstrated. Ki67 is not an independent predictor of clinical CR or pCR. Aspects of ER status beyond its inverse relationship with proliferation may contribute to its predictive value for pCR.

Comparison of different approaches for assessment of HER2 expression on protein and mRNA level: prediction of chemotherapy response in the neoadjuvant GeparTrio trial (NCT00544765)

“…Our findings are in line with other studies demonstrating a predictive value for HER2 expression in achieving a good response to neoadjuvant chemotherapy [27,28]. Until now, the reports concerning the predictive value of HER2 were inconsistent due to heterogeneous study populations and different systemic treatment regimens.…”

Analysis of Clinico-Pathological Characteristics of Indian Breast Cancers Shows Conservation of Specific Features in the Hormone Receptor Sub-Types

“…Subsequent studies on breast cancer specimens from women across diverse geographies and demographics world-wide have confirmed the universality of these molecular classes and their relationship to the well-established immunohistochemistry (IHC) based clinical hormone receptor subtypes [2][3][4][5].…”

Prognostic significance of pathologic complete response and Ki67 expression after neoadjuvant chemotherapy in breast cancer

“…Thus, comparisons of pCR rates between independent trials are not sufficiently reliable to establish superior regimens because subtle differences in patient characteristics, such as ER, HER2, and grade, can have substantial impact. Unfortunately, extensive subsets of patients do not experience pCR, even with modern regimens [6,7]. Long-term survival of patients with residual tumor largely depends on its extent and baseline prognosis [8].…”